Page 42 - Dental Practice Vol 17 No.5_Neat
P. 42

orthodontic section





                                                                                      mandibular canines for wearing light Class
                                                                                      III elastics to achieve better intercuspation
                                                                                      and good overjet and overbite (Figures 4a-
                                                                                      e). Composite build-up was done on incisal
                                                                                      edges  of  11&21.  The  total  treatment  time
                                                                                      was  18  months  with  a  total  of  30  sets  of
                                                                                      aligners. Bonded lingual retainer was given
                                               4a                                4b   from canine to canine in both arches along
                                                                                      with essix retainer.

                                                                                      TREATMENT RESULTS
                                                                                      Post-treatment facial photographs showed
                                                                                      little  change  in  facial  profile  or  smile
                                                                                      (Figures  5a-f).  The  Class  I  molar  and
                                                                                      canine  relationship  was  maintained.  Both
                                                                                      arches showed good alignment, with coin-
                                                                                      ciding upper and lower midlines. Anterior
                                                                                      crossbite  was  corrected  with  good  overjet
                                                  4c                             4d   and overbite. The cephalometric superim-
                                                                                      position (Figure 6b) confirmed the procli-
                                                                                      nation of the upper incisors and retraction
                                        4e
                                                                                      of the lower anteriors. The mandible rotat-
                                                                                      ed anticlockwise due to the slight intrusion
                                                                                      of the posterior teeth which is one of the
                                                                                      common outcomes achieved during align-
                                                                                      er therapy.
                                                                                         The  super-impositions  of  pre-treatment
                                                                                      with  post-treatment  STL  models  (Figures
                                             FIG 4: Class III elastics
                                             for better intercuspation                7a-h) showed arch development in maxillary
                                                                                      arch  with  increase  in  inter-canine  width.
                                                                                      Good retraction of canines in both maxillary
                                              5a                                 5b
                                                                                      and mandibular arch to help alleviate anteri-
                                                                                      or  crowding  and  achieve  good  overjet  and
                                                                                      overbite. Minor change in upper incisor pro-
                                                                                      clination  preventing  flaring  of  maxillary
                                                                                      anteriors.  Correction  of  mesial  tipping  of
                                                                                      mandibular canines. Improvement of peri-
                                                                                      odontal condition of lower central incisors
                                                                                      and correction of midline.

                                              5c                        5d            DISCUSSION
                                                                                      Adults  are  often  averse  to  wearing  tradi-
                                                                                      tional  fixed  appliances  with  wires,  bands,
                                                                                      and brackets. Clear aligners makes it possi-
                                                                                      ble for orthodontists, to offer adult patients
                                                                                      requiring  full-mouth  orthodontic  treat-
                                                                                      ment  an  esthetically  agreeable  solution
                                                                                      using a computer-assisted technology that
                                                                                      produces a sequential series of aligners.
                                                                                         Some aligner companies provide guide-
                                                                                      lines for the types of malocclusion that can
                                                                                      be successfully treated with Clear aligners.
                                                                                      That indicate mild to moderate crowding
                                                                                      (discrepancy: -1 to -6 mm), and/or spacing
                                                                      FIG 5: Post     (+1  to  +6  mm),  non-skeletal  constricted
                                                                      treatment intra  arches,  and  relapse  after  fixed  appliance
                                                                      and extraoral
                                      5e                          5f                  therapy 1 .
                                                                      photographs
              42   Dental Practice // May-June 2021 // Vol 17 No 5
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